Provider Demographics
NPI:1063046985
Name:STREAMLIGHT CORP.
Entity type:Organization
Organization Name:STREAMLIGHT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HADIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-319-8392
Mailing Address - Street 1:66 JACQUES AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3026
Mailing Address - Country:US
Mailing Address - Phone:917-319-8392
Mailing Address - Fax:718-979-0415
Practice Address - Street 1:66 JACQUES AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3026
Practice Address - Country:US
Practice Address - Phone:917-319-8392
Practice Address - Fax:718-979-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health